Preventing Kidney Failure Through Diet

Given how vascular our kidneys are, it should comes as no surprise that animal protein, animal fat, and cholesterol are associated with declining kidney function (microalbuminurea—loss of protein in the urine), which can be an early warning sign not only for kidney failure, but also for heart disease and a shortened lifespan.

Our kidneys are highly vascular organs. That’s why they look so red inside. After all, our two little kidneys have to filter through our entire blood supply, and as such, receive about 20% of our cardiac output, every time our heart contracts. And so, if the standard American diet is so toxic to the blood vessels in our heart, brain, and pelvis—leading to heart attacks, strokes, and sexual dysfunction—what might it be doing to our kidneys?

Researchers at Harvard recently put that question to the test. Thousands of women, and their diets, and their kidney function were followed for a decade. What they’re looking for is the presence of protein in the urine, known as microalbuminuria. There’s not supposed to be any protein in our urine. The whole point of our kidneys is to keep the good stuff in our blood, and get rid of the bad. It’s supposed to hold on to protein, and if it doesn’t, that’s a sign our kidneys are starting to fail.

There were three significant risk factors for declining kidney function in these women—none of which come as a surprise, given that we’re talking about clogged and inflamed blood vessels: “Specifically, diets higher in animal protein, animal fat, and cholesterol may be associated with [microalbuminuria—failing kidneys].” No such association was found for plant protein or plant fat.

And microalbuminuria is kind of a canary in a coal mine, telling you there’s something definitely wrong with your blood vessels. “[Microalbuminuria] and modest decrements in [kidney function] are powerfully associated with subsequent overt kidney disease, cardiovascular risk, and all-cause mortality [meaning a shortened lifespan]. In summary, diets lower in animal protein, animal fat, and cholesterol may be protective against [this kidney damage].”

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Serena.

Our kidneys are highly vascular organs. That’s why they look so red inside. After all, our two little kidneys have to filter through our entire blood supply, and as such, receive about 20% of our cardiac output, every time our heart contracts. And so, if the standard American diet is so toxic to the blood vessels in our heart, brain, and pelvis—leading to heart attacks, strokes, and sexual dysfunction—what might it be doing to our kidneys?

Researchers at Harvard recently put that question to the test. Thousands of women, and their diets, and their kidney function were followed for a decade. What they’re looking for is the presence of protein in the urine, known as microalbuminuria. There’s not supposed to be any protein in our urine. The whole point of our kidneys is to keep the good stuff in our blood, and get rid of the bad. It’s supposed to hold on to protein, and if it doesn’t, that’s a sign our kidneys are starting to fail.

There were three significant risk factors for declining kidney function in these women—none of which come as a surprise, given that we’re talking about clogged and inflamed blood vessels: “Specifically, diets higher in animal protein, animal fat, and cholesterol may be associated with [microalbuminuria—failing kidneys].” No such association was found for plant protein or plant fat.

And microalbuminuria is kind of a canary in a coal mine, telling you there’s something definitely wrong with your blood vessels. “[Microalbuminuria] and modest decrements in [kidney function] are powerfully associated with subsequent overt kidney disease, cardiovascular risk, and all-cause mortality [meaning a shortened lifespan]. In summary, diets lower in animal protein, animal fat, and cholesterol may be protective against [this kidney damage].”

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Serena.

56 responses to “Preventing Kidney Failure Through Diet”

Comment Etiquette

On NutritionFacts.org, you'll find a vibrant community of nutrition enthusiasts, health professionals, and many knowledgeable users seeking to discover the healthiest diet to eat for themselves and their families. As always, our goal is to foster conversations that are insightful, engaging, and most of all, helpful – from the nutrition beginners to the experts in our community.

To do this we need your help, so here are some basic guidelines to get you started.

The Short List

To help maintain and foster a welcoming atmosphere in our comments, please refrain from rude comments, name-calling, and responding to posts that break the rules (see our full Community Guidelines for more details). We will remove any posts in violation of our rules when we see it, which will, unfortunately, include any nicer comments that may have been made in response.

Be respectful and help out our staff and volunteer health supporters by actively not replying to comments that are breaking the rules. Instead, please flag or report them by submitting a ticket to our help desk. NutritionFacts.org is made up of an incredible staff and many dedicated volunteers that work hard to ensure that the comments section runs smoothly and we spend a great deal of time reading comments from our community members.

Have a correction or suggestion for video or blog? Please contact us to let us know. Submitting a correction this way will result in a quicker fix than commenting on a thread with a suggestion or correction.

When I was in high school, I remeber being in the gym bathroom and seeing that many of the guys left behind foamy urine. I always wanted to be like them–muscular, strong, foaming pee. No matter what I did or ate I couldn’t get foamy urine. I was actually embarrased that I couldn’t leave bubbling urine in the urinal. I thought I was unmanly!

I now realize that proteinuria was probably the cause and usually not a healthy sign.

Sorry I haven’t replied sooner but I just got back from Farms to Forks Immerision at Pie Ranch in Pescadero, CA. It was fantastic!

Anyway, you are correct that “foaming pee” is not a good indicator of proteinuria, but I am not talking a few bubbles here (yes I can make foamy urine by urinating at a specific angle in a toilet). ;-O But I’m talking about foam like you would see on the ocean sand (See Below). ;-}

Well OK maybe not that much but see the next pic showing a foamy urinalysis (Below).

The individuals I were describing had foamy pee (albuminuria/proteinuria) that would stay for a long while.

Here is some scientific evidence showing increased proteinuria with high Protein diets:http://www.ajcn.org/content/90/6/1509.long#T3
“Adherence to the diet was also assessed by measuring urea nitrogen (BUN on your labs) excretion in the 24-h urine sample, which was significantly higher in the HP (High Protein) diet phase than in the NP (Normoprotein) diet phase. . . ” (Table 3).http://www.ajcn.org/content/90/6/1509/T3.expansion.html
Here is a statement and link to Proteinuria from the National Institutes of Health:
“What are the signs and symptoms of proteinuria?
. . . Large amounts of protein in the urine may cause it to look foamy in the toilet. . .”
http://kidney.niddk.nih.gov/kudiseases/pubs/proteinuria/

Maybe those kids pee’d at a certain angle or maybe they had significant proteinuria, all I know is . . .

Is there a problem with this video or is it just me? When it gets to about 3/4 of the way through, the video goes black and looses the control buttons. I’ve tried to watch it twice and get the same result.

Excellent! How we can in all good sense keep mistreating our bodies with toxic animla protein is beyond me. Education is the key. Thank you Dr. Gregor for providing short, compelling videos that will in 2 minutes or so change the paradigms of the honest- hearted seeker of nutritional wisdom.

Dr. J I do not speak for Dr. G but read below Groovy Vegans post and mine above to Editor D.

A little bit of research will show you the “badness” of the occasional egg. Maybe you should get Dr. Gregers new DVD. The very first thing he talks about is the detriments of Eggs. They are equivilant to smoking!!!

Eggs have been consistently shown as harmful on this website. The amount of lutein found in a spoonful of spinach is equivalent to 12 eggs, and all the nutrients found in eggs can easily be found in plants. Don Forrester does a good job if linking up the videos.

Toxins, I appreciate your comment. Let me explain where I am coming from: I am both dedicated vegan and a PhD scientist (in the field of biophysics)…I am already convinced of the benefits of a plant-based-diet and do not eat eggs.

The problem I have is that the science of nutrition is a vast subject, so vast that anyone can select articles from the literature and make virtually any argument that they want. Some of the articles selected may not even be reproducible.

What seems more valuable to me the scientific concensus process- which ideally should be based on the views of a majority of scientists in a field and based on the totality of evidence — this minimizes the likelihood of bias. Now, “The Academy of Nutrition and Dietetics” is, according to Wikipedia, the largest organization of food and nutrition professionals in the USA with close to 72,000 members, most of whom are registered dietitians. How much closer to a scientific concensus can you get?

So, if eggs are equivalent to smoking, as Hemodynamic suggests, then why is the scientific concensus telling us otherwise?

From a rational laypersons perspective, who is more likely to be correct: one MD who selects articles from the literature to create videos for a website promoting veganism (and is capable of changing his opinion from one year to the next) or the largest organization of professional dietitians in the world?

I am aware of your strong support of a plant based diet which is why I was a bit confused in your comment. It seems the position of the The Academy of Nutrition and Dietetics is only looking at the nutritional profile of eggs, ignoring what other harmful side effects eggs may entail. Also, the fact they mention eggs as a good source of lutein tells me that there are probable corporate influences within that community, as lutein is abundant in the plant world in far greater quantities and this piece of information is conveniently left out when eggs are being supported. They are also ignoring other outside evidence showing harmful outcomes with the consumption of eggs which I am I am sure your well aware of. The fact that we have cardiovascular and stroke experts and researchers such as David Spence and Jean Davignon explaining the damage that entails with the consumption of a single egg makes me wander if The Academy of Nutrition and Dietetics are even aware of these harms.

In regards to egg whites, although true they are a good source of protein, this is possibly the only positive statement that can be made of it. Here is some evidence of a major component of egg whites, Methionine, possibly causing human harm.

1. Egg whites are high in the amino Acid Methionine. Rice has 14 times less of this amino acid and beans 7 time less. When one consumes Methionine in a large quantity (like that found in egg whites), it is broken down into sulfuric compounds. these sulfuric compounds are buffered by the calcium of the bones. the result, over time, is osteoporosis and kidney stones.http://www.vivalis.si/literatura/6a00.pdf

It seems the weight of evidence for even moderate use of eggs and egg whites is harmful despite what nutrients may be present. Again, I understand your a plant based advocate as well, I am just trying to get my point across that perhaps The Academy of Nutrition and Dietetics is solely looking at the nutritional profile of eggs in making their judgement of its use.

Toxins: thanks again for providing valuable information. I think you are correct about “corporate influences within that community”. It seems that the A.N.D. may not be unrepresentative of the scientific concensus on nutrition.

By the way, according to the wikipedia page on methionine, sesame seeds, brazil nuts and soy protein are also highly concentrated sources of methionine, albeit lower than egg whites.

Soy protein isolates and egg whites seem to be the biggest source, this soy protein is a soy protein concentrate and reaching harmful amounts in normal soy foods would be more difficult to achieve. Soy protein isolates have been shown to increase IGF-1 significantly as well.

BPCveg: I appreciate your comments since I think it is important that we always employ critical thinking when trying to make sense of the world.

However, in this case, your thoughts do not make sense to me. Here’s where I’m coming from:

Remember the video on the Tomato Effect? It shows how scientific consensus is not always about the science. I fully believe that the Tomato Effect happens all the time today, because it is human nature. It is not just a silly occurrence that happened in the past.

Furthermore, it seems to me that a Tomato Effect is exactly what would likely be going on concerning the topic of eggs and the people in the Academy you mentioned. It seems far more logical to me that those people would stick by what they learned in school whether current science continues to support that view or not.

More than just sticking by their early education, there is a *strong* cultural bias for those esteemed individuals to not see the science for what it is when it comes to eating animal products. Dietitians are going to be as strongly influenced by their own desires to continue to eat animal products as anyone else in our society. It takes time to not just educate so many people, but to change their biases. (In the mean time, you and I can look at the latest science and act now.)

Even more, I doubt that all 72,000 members directly validated their Academy’s statement on eggs. I would bet that a very small committee of people who fancy themselves experts came up with the statement and then everyone else quotes from it rather than doing the research themselves. That seems to be the way large organizations like that work. They outed themselves when they talked about lieutine. As Toxins pointed out, that one bit right there makes it suspect that they were looking at the science at all.

I would suggest that the purpose of this site is to show the science whether or not the body of the scientific community has caught up.

Finally, it is not just one study that Dr. Greger picks out of the blue to support a particular view-point. Skip any one study you want. The point is that there is study after study after study that supports Dr. Greger’s big picture. I can’t imagine how anyone could watch all 500 videos and honestly believe that Dr. Greger hasn’t done a very good job of properly representing the “body of evidence”. As an example, I remember Dr. Greger saying in one of his videos something like, “People often accuse me of picking and choosing studies. I don’t. I challenge them to come up with a single study that ___” I don’t remember the exact challenge, but the answer was, “They can’t because there isn’t a single study out there.”

I’m sure there are studies that show that eggs can have some benefits. The point, though, is to look at the “body of evidence”. Given politics and people’s desires not to change, I think we get a better overview of the body of evidence from this site than the Academy provides when it comes to animal products.

I didn’t explain myself very concisely. My appologies. And I want to say that I’m not trying to be argumentative. It’s just that your comments challenged me. I felt your comments were particularly good and it was my responsibility to be able to answer such thoughts for myself. Then I decided to write them out. Thanks for your comments.

Thanks, Thea, for your excellent response to my question. Your perspective does seem very reasonable to me and, of course, I agree with you that the general message of Dr.Greger’s website is on the right track.

Despite my strong support for a whole foods plant based diet, I have had conflicted feelings about rejecting the opinion of the Academy (who recommend eggs, fish and dairy) mainly because of my respect, in general, for scientific concensus. I think the critical scientific community is very good at weeding out extreme and bizarre viewpoints and that this process is very valuable and should be respected by the public. That was my reason for lending some support to the claims of the Academy.

I came up with another idea over the weekend. I was feeling that my post had a hint of anti-science in it, and I am not like that at all. Like you, I think the process of scientific consensus building is extremely valuable.

Then I remembered a young friend from a couple years ago who was studying to be a registered dietician. We had several conversations about her education. While she talked about learning the results of a fair amount of science, her education was all about taking in information – not about how to do experiments, understand them, and participate in the scientific community. Contrast that experience with my roommate in college who was getting a BS in biology. She was running scientific experiments and learning about the process from day one.

My point is: Based on my very limited understanding of what a registered dietician is, they are professionals, but not necessarily scientists. There is a difference between a professional and a scientist. I have no reason to believe that non-scientists would have processes that are similar to something that you would recognize as building “scientific consensus”.

That’s it. It just made me feel better to think that the Academy may not be up on the science since they are not (at least to my knowledge) actually scientists. Which is not to say that they don’t try to keep up. I just think that their assimilation of the latest experiments would be different compared to someone who is in fact a scientist.

I don’t know how legit this idea is. I just thought I would throw it out there.

If any dieticians are reading this, please don’t take this the wrong way. I’m a professional too. I just recognize a difference between my profession and being a scientist.

Your conflicted feelings make perfect sense to me. The conflicting information pushed by “expert” organizations and the media is something that the general public is dealing with every day. The available information is both conflicting and confusing. People are often left feeling that the science does not actually point anywhere since it seems like anyone can make the science appear to say whatever they want. I come across (and work to fight) this belief constantly.

I’m not saying you have this belief. I’m just saying, if you, as an educated person and a plant-advocate, are struggling with trying to find out what the science tells us about nutrition, it is perfectly understandable and no wonder that other people are thoroughly lost. It is important that we, (plant advocates/professionals/vegans?), be able to answer these types of questions. And thus, we owe thanks to those people who keep us on our toes by doing the asking.

I think you made a really interesting argument about how people in the medical professions may interpret new scientific data differently from those who are actually conducting scientific experiments. Of course, I am sure you would also agree that both of these groups can bring something valuable to the table. Like you, I try to be as open to as many points of view as possible.

Although I agree with the general message of nutritionfacts.org and think that this website makes a valuable contribution to educating the public, I have some doubts as to whether this site offers a completely balanced perspective. It seems to me that Dr. Greger does look at things through a vegan lense.

I would like to be able to compare Dr. Greger’s views with those of other experts in nutrition. That way I can learn Dr. Greger’s views in comparison with the mainstream scientific view.

Anytime you are evaluating nutrition information, it is important to keep in mind the source of that information. What are the credentials of the author or speaker? Do they have a hidden agenda for promoting a certain food? For example, the egg board would like the American public to believe that eggs are a healthy part of anyone’s diet. I disagree. When I am looking for the consistency of scrambled eggs, I use extra firm tofu with a pinch of turmeric, onion powder and salt. Saute in a little olive oil and add onions, peppers and mushrooms if you desire. Throw in some veggie sausage and you have a very satisfying, high protein and cholesterol free breakfast! Thanks for your question!

I also find that tofu, ***when cooked just right***, has the consistency of scrambled eggs.

That’s consistency, but what about taste? As you describe your recipe, the taste can be very good. But here is a tip making tofu taste a little more like eggs: black salt.

I read this idea recently in a vegan cookbook. The author said that the black salt does something to really help the tofu have an eggy taste. I had to order the black salf off the internet recently, so I can’t yet attest to this assertion myself. After reading your nice post, though, I wanted to share the tip before I forgot.

My father had a kidney transplant last year, and it’s high time people put thought and effort into preventing kidney disease, rather than waiting until their doctor tells them their kidneys are failing. I sent a link to this video to some doctors I know to share with their patients.

I have a friend who’s father had sudden onset of kidney failure with no obvious symptoms leading up to it. Went on dialysis and died withing a few months. Another silent killer. For me, better to be safe than sorry.

I would have liked the data to be longer. I was diagnosed with end stage renal failure in October 2011. I was asked to sign a consent form for immediate dialysis. That evening I spoke to a Nephrologist who asked if I would like to try reversing it by diet before undergoing dialysis. I agreed. Problem: Neither Nutritionist nor M.D. has been able to furnish me with a diet I can easily follow at home.

There’s a doctor in North Vancouver, Canada by the name of Dr. John Matsen, who treats liver and kidney dysfunction. He’s got an interesting book called: Eating Alive II: Curing the Incurable (with recipes), and a website – http://www.eatingalive.com/

How “easy” does it have to be, when the alternative is DIALYSIS???
Read Forks Over Knives and search the internet for discussion groups and recipes to find out how to stock a kitchen, buy a food processor and high-powered blender, substitute ingredients in standard recipes, etc.

However, because Cancer Prevention and Treatment May Be the Same Thing in many cases, I would recommend you consider eating the kind of diet that has been associated with kidney cancer prevention. For example, in the current issue of one of my favorite journals, the American Journal of Clinical Nutrition, this question was put to the test in what may be the largest prospective study ever, the NIH-AARP Diet and Health Study, which followed nearly half a million people for about a decade. Noting that “Plant-based and fiber-rich diets high in vegetables, fruit, and whole grains are recommended to prevent cancer and chronic conditions associated with renal cell carcinoma, the study found fiber intake was associated with a significant 15-20% lower risk of renal cell carcinoma and that the most powerfully protective foods included legumes (beans, chickpeas and lentils), whole grains, and cruciferous vegetables. Refined grain intake, however, was associated with increased risk. Last year the same group of researchers found that cooked meat carcinogens may double the risk of papillary renal cell carcinoma. The only other new study I know of found that nitrite from processed meats and other animal sources (but not plant sources) was associated with an increased risk as well.

Finally, given that most of the new treatments developed for renal cell carcinoma (Axitiniband, Bevacizumab, Everolimus, Pazopanib, Sorafenib, Sunitinib, Temsirolimus) attempt to block the formation of new blood vessels to the tumor, that would be all the more reason to pack your diet with foods containing anti-angiogenic phytonutrients such as

apigen, luteolin, and fisitin such as strawberries, citrus, celery, peppers, and other fruits and vegetables. I have a video coming out soon on this whole concept called Cutting Off Tumor Supply Lines. Stay tuned!

Hello Dr. Greger. What can you tell me about treating Nephrotic Syndrome? My son is 4 and was diagnosed with this a few months before his 3rd birthday. He’s had two relapses since, and has taken prednisone for it each time. Any information you have on it would be greatly appreciated! Thanks!

I went on a plant based diet 8 months ago and guess what… ? I’m currently in hospital with worryingly impaired kidney function! I’m 34. The moral to the story is to not precede 8 months of plant based eating with chronic over indulgence in animal protein and a propensity to consume protein and creatine supplements! I’m going to do my best to heal myself with diet because I was feeling great before this latest episode.

?? So, the presence of protein in the urine is a sign of kidney problems … so that is being spun as causing it, and that is being spun into don’t eat a lot of protein, and that is being spun into … be vegan? That is a long and tenuous chain, and I’d just like to understand the full claims. Diabetes is sugar in the urine, right? Does that mean that sugar causes diabetes, or that one should never eat sugar? I think everyone who has ever lived to any age has eaten sugar and protein, so why the hyperbolic reasoning, why not a more nuanced approach to finding exactly where, when and why medical problems start?

My husband had kidney failure this year and is on dialysis. It seems that the diet with kidney disease (prior to kidney failure) prescribed was radically different from what the nephrologist and dialysis center are suggesting now that he is on dialysis. He is now told to eat a lot of protein in order to increase his albumin including ALL types of animal protein. They are really pushing meat and eggs, etc. We are told that patients with higher albumin have better outcomes from the research. Although phosphorus is a problem too (and found in meat and dairy). Does your research provide any information about kidney dialysis patients and diet??

Hi Dr. Geger, I am vegetarian (total-no meat, milk, cheese, egg). I suffered with preeclampsia in three of my pregnancies. I am now stuck with high blood pressure and lowered kidney function. What can I do to get rid of the high blood pressure and to rejevenate my kidneys?
Your answer would really help me and many women. I know of several women that have had the same problem after thier
pregnancies.
Big thanks to you and those who help you make this site a health resource to the world.

Thanks Joan, I appreciate your helps. I will be working with an endocrinologist to see if any truths emerge and will try to keep you posted as we make headway.
I’m just restarting taking flaxseed meal to see how it can help lower my bp.
God bless you and take good care.

Hello, I had a nephrectomy as a child so my only kidney grew to compensate for it. Long story short im looking for dietary advice to protect my one kidney long term. I read through your articles and watched your videos about the benefits of sticking to a veggie protein based diet. Now when you talk about animal protein would that make protein such as goat/cow whey supplements horrible for the kidney more so than eating the actual meat from those animals? Additionally, are certain meats worse offenders than others for kidney stress?

Hello, I have been a vegan since 2001. I was put on the kidney diet in 2008, and in 2010 was told to choose the type of dialysis I wanted because I would be on dialysis that year. I incorporated the kidney diet while continuing to eat plant-based, even though initially, with the proscription against ingesting too much potassium and phosphorus, it seemed daunting as best.. Here it is 2018, and my kidney function has declined so slowly, I am still not on dialysis. Kind of remarkable. My nephrologist has told me my plant-based diet is largely responsible for the slow decline. On the advice of a friend, I am trying to write up an account of the benefit to kidney patients of the plant-based diet.
My concern is this–I have just read Paul Shapiro’s “Clean Meat”. With an eye to the future (I don’t want my little writing project to soon be obsolete), I wonder whether Dr. Greger feels that cultured animal protein, when stripped of its harmful toxins, cholesterol and antibiotics, and maybe even with beneficial fats added into the new “meat” in the form of omega 3’s, would still be a poor choice for a kidney patient. In other words, in a clean meat future, would it still be best for kidney patients to consume a diet free of meat, regardless of whether it is cultured or not?
Thank you. Elizabeth Fletcher

Elizabeth,
I hope Dr G will address the “Clean Meat” in the future. I recommend that you proceed to write up your experience and your dietary approach and results. Many can learn from your experience. Regarding eating “clean meat,” its more that the saturated fat and toxins.The actual protein in animal products appears to present problems when we eat it. Check out the following link. https://nutritionfacts.org/topics/protein/

Thank you so much for your prompt response. I have looked at the link on protein and am much encouraged about both my diet and my project.
I am so glad also that I have joined Dr. Greger’s website. I have the pleasure of hearing him speak every year at the Boston Veg Food Fest,
and now look forward to the information on nutritionfacts.org.
Elizabeth